The effect of low molecular weight dextran (LMWD) on blood coagulation was studied in 66 patients who underwent normothermic open heart surgery using extracorporeal circulation with a disc oxygenator. These patients were divided into two groups. In one group, the LMWD group (53 patients), 10% LMWD solution (average molecular weight of LMWD was about 40, 000) was added to the priming blood (the administration percentage of LMWD to whole blood was used solely as the priming blood.
Changes of blood coagulation in the course of surgery were observed, and differences of the changes were compared with in both groups.
The following results were obtained:
1) The changes of Thrombelastogram: In the whole blood group, r, k, and r+k values were shortened and ma value was increased; however, in the LMWD group, r, k, and r+k values were prolonged and ma value was decreased.
2) In changes of blood platelet counts and prothrombin time, no significant difference was observed in both groups, but decrease of plasma fibrinogen level was greater in the LMWD group than in the whole blood group and the difference was statistically significant (p<0.05).
3) Fibrinolysis did not occur in both groups at all.
4) The corelation between the administration percentage of LMWD (from 7.4% to 14.7%) and prolongation of k value, r+k value was recognized, and the corelation of administration percentage with the decreasing ratio of ma value was also recognized.
5) It was demonstrated that in cases more than 8.8% administration percentage of LMWD, hypocoagulability occurred.
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